By A Concerned Citizen
There are moments in public policy when the machinery of government begins to move in ways that even its own operators struggle to explain. Australia’s shift to the new Support at Home program is one such moment – not because reform wasn’t needed, but because the system that has replaced the old frameworks appears designed without sufficient regard for the people working inside it, the people relying upon it, or the inevitable consequences of sweeping automation in a sector built on human judgement.
If you haven’t been following the rollout closely, here’s the simplest way to describe it:
We built a system that determines older Australians’ care needs using an automated tool so complex that even the Department avoids explaining how it works, then removed the ability for qualified clinicians to correct it when it’s wrong.
Predictably, the system is wobbling.
Predictably, nobody can agree on why.
And predictably, the people copping the fallout aren’t the ones who designed it.
A Profession Under Strain – And Why Walking Away Helps No One
Across the country, assessors, clinicians, OTs, and social workers – the people who spend their days in lounge rooms, hospitals, and aged-care facilities helping older Australians maintain independence – are questioning whether they can stay in a system that seems determined to hobble their judgement.
One sentiment is cropping up everywhere:
“I want to quit – not because I can’t do the work, but because the system won’t let me do it properly.”
And it’s true: many staff are physically and emotionally exhausted.
Many feel their professional competence is being questioned by a rules-engine that sometimes overlooks what any human clinician can see plainly.
And many fear they’re being pushed out so the system can be deskilled, outsourced, casualised, or automated further.
But here is the difficult truth:
If the entire skilled workforce walks, the people who designed this mess will call the collapse proof that ‘the model must change’, not that they broke it.
They will not see resignation as protest.
They will see it as permission.
That’s why leaving en masse – however justified it may feel – only gives victory to the very forces that want a cheaper, less qualified, more compliant workforce.
Staying is not capitulation.
Staying is resistance.
Staying preserves the one thing they cannot automate:
clinical judgement grounded in ethical practice and real-world experience.
Where This Is Heading – And Why the Workforce Will Eventually Win
The Support at Home algorithm is already generating outcomes that don’t match reality.
Media outlets are reporting cases where older people with high needs are assigned minimal support, while others with similar profiles receive wildly different results. The Department insists it’s “not AI”, but functionally it is: automated decisions, opaque logic, and no right of override.
And here’s the funny thing about flawed automated systems: they always collapse under their own weight.
- Robo-debt did.
- NDIS automation did.
- Centrelink’s risk engines did.
- The UK care algorithm did.
- And this one will too – not because critics demand it, but because costs explode when humans are treated as data points.
Every incorrect classification leads to a complaint.
Every complaint leads to a reassessment.
Every reassessment leads to more government spending.
And reassessment rates will soar.
When Treasury realises the “cost-saving algorithm” is costing more than the old human-driven system, the calls for reform will move from whispers to Senate questions to headlines.
And when OPAN, COTA, gerontologists, unions, and the public line up behind stories of unmet need, it will become politically impossible to maintain the current rigidity.
That is when the workforce – bruised, exhausted, but still standing – will be needed most.
Why Staying Matters
There are three reasons Australia needs its assessors, clinicians, and care coordinators now more than ever:
- Reform collapses without witnesses: If skilled staff vanish, the narrative becomes “the workforce failed,” not “the system was broken.”
- Only clinicians can articulate what the algorithm gets wrong: The public trusts nurses, OTs, social workers, GPs, and allied health. They don’t trust “digital reform frameworks.”
- When the correction comes – and it will come – it must be shaped by the people who know what good care looks like.
If the workforce is absent, the next iteration will be more automated, more cost-cut, and more dangerous.
This is not blind optimism.
This is pattern recognition.
Every failed automated welfare reform in the past decade has ended the same way: humans had to fix what machines broke.
But humans must still be there to do it.
What Gives Hope?
Even in this messy period:
- Advocates are already speaking out.
- OPAN is reporting rising confusion and dissatisfaction.
- Media outlets are beginning to examine algorithmic decision-making and lack of transparency.
- Senators are asking pointed questions about the classification system.
Providers are warning publicly that low-level packages cannot purchase enough hours to meet even basic need.
Cracks are appearing.
Light always gets in through cracks.
And in the meantime, the people who remain – the ones still assessing, still documenting, still noticing patterns – are building the evidence that will force change.
This evidence is what will ultimately protect older Australians from a system that has rolled out faster than it has stabilised.
Clarke & Dawe: The Algorithm Interview
Bryan Dawe: So, you’ve replaced clinical judgement with an algorithm?
Department Spokesperson (John Clarke voice): No, Bryan, that would be irresponsible. We’ve simply arranged things so the clinician enters the data, and the algorithm makes the decision.
Dawe: But the clinician can’t change it?
Spokesperson: Exactly. We respect their expertise too much to let them interfere.
Dawe: The algorithm – has it been tested?
Spokesperson: Of course! We asked it how it felt about itself and it gave a very positive response.
Dawe: And older Australians?
Spokesperson: Oh, it’s confident they’ll adjust. Algorithms are remarkably adaptable.
Dawe: So if the algorithm gets it wrong?
Spokesperson: It doesn’t. If the outcome is wrong, the person is wrong.
Dawe: And reassessments? Complaints?
Spokesperson: We see those as expressions of engagement with the new model.
Dawe: It sounds like chaos.
Spokesperson: No, Bryan. Chaos would suggest a lack of structure. We’ve structured this very carefully.
Footnote:
“Somewhere, a consulting firm is polishing a slide deck explaining how this is actually a success.”
In the End
Australia’s aged-care system will stabilise again – but not because someone in an office decrees it so. It will stabilise because:
- clinicians stay just long enough to expose the flaws,
- advocates amplify the evidence,
- journalists follow the paper trails, and
- governments eventually accept that dignity and care cannot be automated away.
If the people who know the system best hold their ground – even shakily, even wearily – they will be there to help rebuild it when the pendulum swings back toward common sense.
And it always does.
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https://open.substack.com/pub/shanakaanslemperera/p/the-cognitive-collapse-thesis-how?utm_campaign=post&utm_medium=web
Thanks Lesley de Voil,
A great resource and interesting read. One can but wonder whether the appropriate Oz PS Departmental folk and Minister Tim Ayres are across this Co-degeneration Thesis, and what provisions they have made.
I will be 96 in a few days, & as an elderly retired war widow, I have been completely over whelmed by the paper work & phone calls plus emails, resulting my health deteriorating under the stress
Thank you for your letter which has clarified some of the difficulties
phone
I am 84 and have decided not to go down that road,it’s all too stressful and too expensive and not what Senior people don’t need after paying their taxes for many years,and people who came from the tough times, with no dole excetra,worked hard,we paid for the dole, baby bonuses NDIS,our parents pensions,and now we are considered a burden.so thanks for nothing, Albosleazy
Home Care Package program was introduced to keep Aged cheaply in their homes instead of in hospitals with nowhere else to go.
SAH was poorly planned, poorly financed and poorly communicated.
Australia’s “mean streak” Robodebt moves onto the Aged.
Inexperienced first-time Ministers out of their depth, controlled by bean counters.
The government’s finance sub-contractors, The Providers, are winners, eg 10% loading on every invoice submitted for services!
People’s deterioration from lack of adequate home support under SAH will likely overload the hospital system by next winter.